Diagnosing Problems in Groups and Teams

We tend to think we bring together a group of people, and they will be high performing

It doesn’t always work! How can we identify the problems?

Example: steering committee on an organisational development initiative

Interesting patterns:

Every time the team met in person, lots of laughter and jokes. The were agreeable on almost anything that was discussed during the meeting

However, after the meeting, lots of emails sent raising numerous issues, which were not discussed during the in-person meetings

The next time they met, none of the issues were raised

The culture of politeness

We’re interfacing with each other, face to face, we’re going to be polite

“Real” issues are secondary to being polite

Being polite gets in the way of learning in organisations

The pattern of repeating

Even when contentious issues are raised, other people in the meeting disengage and lose focus. They’re not wanting to signal agreement or disagreement.

The speaker worries that they don’t get acknowledgement, so they repeat the same thing, a bit louder and more exuberant.

“I’ll do it again, and they’ll get it this time”

Not breaking the the frame, not stepping back or taking some sort of time-out.

Conflict is often avoided

People don’t feel the need to confront each other

They’re not comfortable dealing with conflicts

Undiscussable issues are not discussed during meetings

Conflicts are discussed outside of formal meetings, over a lunch or a beer

How to interrupt the negative cycle

Pause, and raise the question of “What’s going on here?”

Make the pause part Ground rules.

Allow the team to re-frame and refocus

It needs to be a deliberate activity

The leader needs to help establish that this an effective and acceptable practice in the team

Examples:

work teams in factories can stop the whole production line

retrospectives

Try to identify what the issue is

Where is the team is getting stuck?

Collect a little data.

Ask everyone on the team:

What’s working well?

What isn’t working well?

Do an anonymous survey if people are uncomfortable talking in the open about what the issues are.

Don’t just make assumptions. Really try to figure out what people are seeing

Scenario: Healthcare, Part 1

Background

Hospital in a major metropolitan area that is busy 24 hours a day

Doctors and nurses are rushing about

There is tremendous paperwork behind every job that gets done

There is a grave problem:

Patients come in to the ER, and are waiting to be admitted to a bed in the hospital

Between their time in at the ER, and getting to the bed, there is a lag of time.

Sometimes, patients have waited up to 7 hours in a hallway in a gurney waiting for the bed to be available.

Who’s at fault?

Who can find a solution to this problem?

Cross functional team to solve the problem

Senior physician is leader

Representatives from nursing, facilities, safety, and housekeeping

Only 10% of the 2 hour meeting has everybody there trying to solve this

Chief medical officer:

We have too many patients waiting in the hall.

We’re getting calls all the time, looking for beds

What’s the problem?

Head of nursing:

By the time housekeeping has finished with the room, we have to put it in, confirm it, by the time we get the information to you (chief medical officer), it’s too late. Hours have passed.

Head of health and safety:

It is an infrastructure problem. We need better phone lines, better IT

Director of facilities and infrastructure

That is absolutely untrue. New phone lines, new IT system. That’s review board and a huge budget

<<crosstalk>>

Head of nursing:

We don’t even know if it’s going to work

<<crosstalk>>

Chief medical officer:

If it helps communication, I agree that it might be a good idea. We need to talk about it

Director of facilities and infrastructure:

it’s just a way over the top solution.

<<crosstalk>>

Head of nursing:

It’s just another thing that I have to teach an entire staff of people

Director of facilities and infrastructure:

I think the infrastructure problem is a personal infrastructure, there could be a way to open that.

Chief medical officer:

Yes, but listen, we have the finances to do whatever we need

Head of nursing:

If we have the finances, we should be hiring more nurses

<<crosstalk>>

Head of health and safety:

Is that the problem?

Head of nursing:

Yes, that’s the problem!

Head of housekeeping:

There are people in the rooms who are cleaning. They can do the job, they can report directly.

Head of nursing:

Yeah, but we need to have checks in place

<<crosstalk>>

Head of nursing:

Unfortunately, your staff can not be counted on (talking to housekeeping)

Director of facilities and infrastructure:

There is a huge competency problem. Huge! They don’t show up, they take 25 minute smoke breaks.

Head of housekeeping:

You’re not even on our floor.

Head of nursing:

But I am, and I feel like I consistently have problems and rooms are not cleaned consistently and adequately

<<crosstalk>>

Chief medical officer:

The problem is if the beds are not prepared, then we are in deep shit.

Director of facilities and infrastructure:

There’s a way we could work within this infrastructure personally

Head of nursing:

I just feel incredibly frustrated. I have almost no staff, and I have another team that feels unwilling to work with us, and if I could find a way…

Chief medical officer:

How hard is it to pick up the phone? That’s what I want to know.

(walks off)

Head of housekeeping:

(to head of nursing) My staff can work with your staff, they just don’t need to, they can go directly.

Head of nursing:

I’m unwilling to have these conversation when not everyone is present

Director of facilities and infrastructure:

Shall we table this for next week?

Chief medical officer:

(walks back)

So, how are we doing?

Director of facilities and infrastructure:

We are nowhere.

Debrief: Scenario, Part 1

It was a shouting match, no one listening

There was a lot of blaming

Chief of health and safety blamed an entire housekeeping department for not being competent

Chief medical officer seemed very uninterested.

Not even physically available for the entire meeting

Left to take a call

No solution focus

When we’re in a “fight” situation, our guards go up and we protect ourselves from blame.

Defensive routines (Agyris)

Triggered when we feel attached

“My group did our part”

“It’s not our fault”

There’s very little communication.

Teams need to find a way to reframe “fights” to “an exchange of ideas”, or something constructive

Stepping back and listening, as opposed to just asserting your own view points

Can we voice what the assumptions are?

That prevents them from going underground, getting buried

Scenario: Healthcare, Part 2

Background

Let’s assess the previous meeting, so that we can make some structural changes to the way that they communicate

Chief medical officer:

I think the last meeting was difficult. I think we need to find a way to make our meetings more effective so that we can solve the problem at hand

There’s no hierarch. Everyone is free to express themselves.

What did we do wrong in the last meeting?

Head of housekeeping:

It was not good. Everyone talked over everyone else.

Director of facilities and infrastructure:

Well, this is progress. We are laughing at each other.

I feel like if we’re really going to be focused on what we’re focusing on, we can’t keep taking calls in the middle of meetings.

Head of housekeeping:

In regard to staying focused, I think we really need to listen to everybody. I did not feel heard at the last meeting. I felt there was definitely a pecking order going on.

Chief medical officer:

Well, why don’t we just go around and one person at a time take a minute, say what they need to say with no interruptions.

Head of nursing:

We for me the last meeting was really frustrating because I felt ganged up on, and there was no one stepping in. We nurses are overworked as it is, and we hardly have a chance to catch a breath more or less. I think two or three times, steps down the line.

Head of health and safety:

Guys, it’s easy to point fingers, and point out where other people drop the ball, but I think we could all do a lot better with less blame.

Chief medical officer:

Something I really would like is if people could come from their own departments with ideas from their own departments that might solve the problem at hand, and think about it ahead of time.

Head of housekeeping:

I feel like I did do that. I did come to a meeting with a solution I’d thought of that didn’t get heard. A lot of assumptions were being made about the skills of my staff. Nine times out of ten, the room is clean when the nurse comes to check it. My housekeeper could enter that into the system, get that message to the ER right way, save you time and work. I hired the staff. I know that they can do it.

Chief medical officer:

I don’t think that the housekeeping are going to solve this problem. I mean, this is a really high takes problem, this is a big deal.

Director of facilities and infrastructure:

Well, just to point out in the open format, you just made the assumption that Sarah was talking about, that housekeepers somehow can’t do it.

Chief medical officer:

Okay, all right, duly noted.

Head of nursing:

I does seem sometimes that we aren’t listening and we’re pushing too hard with our own ideas.

Chief medical officer:

How about is somebody vould volunteer to write down what is being said in the meetings, because I know everybody’s got on their mind, and then distribute it.

Head of housekeeping:

I’m happy to do that.

Chief medical officer:

Great. Maybe write down your proposal.

Debrief: Scenario, Part 2

The team takes time out, and is able to step back and review its own operation

It will take time to get these “retrospectives” working well

In this space, people have time, they are listened to, they are “in” the space.

The leader plays an important role in shifting the focus of the meeting

They have to give a green light to allow the meeting to progress (e.g. without hierachies)

They have to be careful not to fill the meeting space with their own voice

After Action Review

A meeting to assess what we just experienced

In the meeting you’re calling a timeout.

We want to examine what just happened, and figure out a better way.

The leader models the behaviour

e.g. I’m turning off my cell phone

Need to deal with specifics.

“We all need to listen to each other.”

No! Let’s examine the times when people didn’t listen to each other. Let’s be specific and detailed, not vague and general.